National Center for PTSD

Hematopoietic stem cell transplantation (HCT) is an intensive and invasive procedure used in cancer treatment that depends heavily on the involvement of caregivers and places them at high risk for posttraumatic stress disorder (PTSD) symptoms. These symptoms are frequently overlooked in oncology and general health care settings. The suitability and utility of the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) within cancer caregivers remains uncertain. This study sought to evaluate its performance as a brief (five-item) case finding screening alternative to the longer (20-item) PTSD Checklist for DSM-5 (PCL-5) in caregivers of survivors who received an HCT 1-5 years ago. A total of 106 caregivers completed the PC-PTSD-5 and PCL-5 during recruitment for a randomized clinical trial. Optimal cut scores for identifying probable PTSD and item performance were determined using indices correcting for chance and item response theory analyses. Of the caregivers evaluated, 33% screened as positive for probable DSM-5 PTSD using the PCL-5. The PC-PTSD-5 exhibited acceptable internal consistency and significant associations with PCL-5 scores (total, r=0.79; items r [range] [0.60-0.69]). A cutoff score of 3 provided optimal sensitivity for screening (κ[Se] = 1). Item response theory analyses indicated the need for the complete PC-PTSD-5 items to provide the greatest information across varying levels of PTSD. Although not an instrument validation study, these findings provide preliminary support for using the PC-PTSD-5 as a succinct, effective screening tool among cancer caregivers in a clinical context.

Objective: Sexual violence predicts both posttraumatic stress disorder (PTSD) and distress during gynecological health care. Yet sexual trauma represents only one event that can precipitate posttraumatic distress, and less is known about PTSD and gynecological-related factors in survivors of nonsexual trauma. We examined PTSD symptomatology and gynecological-related factors in 1,185 women veterans with diverse trauma histories. Methods: This cross-sectional analysis leveraged data from a national survey. Women self-reported their lifetime history of sexual violence (any versus none); military sexual trauma (MST) exposure (no MST, harassment only, assault); PTSD symptoms; distress experienced during gynecological care; and gynecological health care-seeking. Analyses assessed whether associations between PTSD symptomatology and gynecological-related factors depended on lifetime or military-specific sexual trauma. Exploratory analyses considered whether certain PTSD symptom clusters (Criterions B-D: re-experiencing, avoidance, negative cognitions/mood, hyperarousal) particularly contributed to distress. Results: Greater PTSD symptoms were linked with greater emotional distress, physical discomfort, and fear during gynecological exams; these associations did not depend on lifetime sexual violence, though there was some variation by MST type. Greater Criterion D and E symptomatology uniquely accounted for distress across most indicators. Analyses considering health care-seeking largely yielded null findings. Conclusion: Posttraumatic psychopathology is relevant to gynecological-related distress in trauma-exposed women veterans, regardless of lifetime sexual trauma, and certain symptoms-including negative thoughts/feelings and hyperarousal-may be especially pertinent. Further, MST may compound the effects of PTSD on gynecological care experiences. Findings support assessing gynecological-related distress in all trauma-exposed women exhibiting PTSD symptoms and emphasize the need for trauma-informed reproductive health care.

ABSTRACT Background: The RESET (Reconsolidation, Exposure, and Short-term Emotional Transformation) clinical protocol is an intensive, structured trauma-focused intervention designed to treat post-traumatic stress disorder (PTSD) within six daily sessions. While Prolonged Exposure (PE) therapy remains a leading evidence-based treatment, challenges such as high dropout rates and relapses highlight the need for innovative approaches. Objective: This paper outlines RESET's theoretical foundations, session structure, and clinical implementation, offering a detailed framework for its integration into psychotrauma practice. Method: RESET integrates principles of memory reconsolidation, exposure therapy, and psychodynamic case formulation to facilitate the rapid processing and integration of traumatic memories. The protocol includes psychoeducation, targeted exposure, dynamic case formulation, and guided trauma processing, providing a comprehensive yet time-efficient intervention. Results: By leveraging memory reconsolidation mechanisms within an intensive treatment format, RESET has the potential to enhance therapeutic engagement, reduce dropout, optimize PTSD symptom reduction, and foster sustained emotional processing. Its structured design ensures feasibility and adherence while maintaining the efficacy of traditional PTSD treatments. Conclusions: Ongoing clinical trials are evaluating RESET's effectiveness across diverse populations, positioning it as both a scalable stand-alone intervention and a valuable adjunct to long-term psychotherapies.

BackgroundAlzheimer's Disease and related dementias (ADRD) are under diagnosed and that under diagnosis if detrimental to patients, their families and the VA Health Care System. This crisis of under diagnosis exacerbates existing disparities in healthcare, disproportionately affect Black Americans (BAs) compared to White Americans (WAs). Using a machine learning (ML) model to assign ADRD‐risk scores may help to identify Veterans with undiagnosed ADRD and their risk of developing dementia in the near future.MethodWe previously developed a ML model based on 850+ variables extracted from structured and unstructured data from the VHA's vast electronic health records, using a training sample of 20,000 BA and 20,000 WA Veterans. Kaplan‐Meier curves were calculated separately for race and ML score quintile group. A Cox‐proportions hazards model was used to obtain an estimate of the hazard ratio (HR) for the risk of developing ADRD.ResultThe HR comparing the 75th to the 25th percentile of scores is estimated to be 2.20 (95% CI, 1.93‐2.51, p < 0.01). The Kaplan‐Meier plot showed differences in risk for converting to ADRD between races; for BAs, the curves of the highest two quintiles have visibly steeper slopes than those for other quintiles; for WAs, only the highest quintile have visibly steeper slopes than the other quintiles.ConclusionHigher ML scores were associated with higher risk of developing ADRD in the years following the index date. BAs in our sample were at a higher risk for developing ADRD compared to their WA counterparts with the same score.

Brenner et al. (2021) developed and initially tested two computerized adaptive measures of posttraumatic stress disorder (PTSD), one that provides a provisional diagnosis (PTSD computerized adaptive diagnostic screen [CAD-PTSD]) and one that estimates symptom severity (PTSD computerized adaptive severity test [CAT-PTSD]). We expanded on the initial psychometric findings by collecting data regarding test-retest reliability, incremental validity, and respondent burden. A sample of veterans (N = 156, 32% women, 36% Black, 13% identified as Spanish, Hispanic, Latino, Puerto Rican, or Cuban) recruited from three Veterans Affairs medical centers completed the CAT-PTSD and CAD-PTSD, the Clinician-Administered PTSD Scale for DSM-5, the PTSD Checklist for DSM-5 (PCL-5), Primary Care PTSD Screen for DSM-5 (PC-PTSD-5), and a battery of other self-rated scales. Fifty-three participants (34%) completed the measures a second time within 7 days (Mdays = 5.41; SD = 1.97) of their first visit. CAT-PTSD scores revealed good convergent validity (r = .78 with Clinician-Administered PTSD Scale for DSM-5 total score), discriminant validity, and test-retest reliability (r = .80). Scores on the PCL-5 and PC-PTSD-5 had similar characteristics. The CAD-PTSD demonstrated poor diagnostic efficiency, κ(.5, 0) = .40, and test-retest reliability (κ = .25), whereas previously established cut-scores for the PCL-5 and PC-PTSD-5 showed fair to good diagnostic utility and adequate to good test-retest reliability. Results suggest that the CAT-PTSD may provide a valid indicator of PTSD symptom severity, but does not offer incremental value beyond the PCL-5 and PC-PTSD-5. The CAD-PTSD was markedly inferior to the use of PCL-5 or PC-PTSD-5 cut scores. (PsycInfo Database Record (c) 2026 APA, all rights reserved).